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General NPI Number Information
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NPI Number | 1447671409
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Entity Type | Organization
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Legal Business Name | KINDERHOOK DENTAL ARTS PC
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Dates
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Enumeration Date | 12/18/2013
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Last Update Date | 12/18/2013
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Provider Practice Location Address
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Address Line | 2870 US HIGHWAY 9
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City | VALATIE
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State | NY
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Zip | 12184-9401
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Country | US
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Telephone | 518-758-7179
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 788
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City | VALATIE
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State | NY
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Zip | 12184-0788
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Country | US
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Telephone | 518-758-7179
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DAVID STARKMAN
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Credential | DDS
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Telephone | 518-758-7179
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 037142
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License Number State | NY
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